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General NPI Number Information
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NPI Number | 1154277002
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Entity Type | Individual
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Provider Name | YANELLE NIEVES
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Gender | Female
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 1289 ROUTE 38
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City | HAINESPORT
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State | NJ
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Zip | 08036-2730
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Country | US
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Telephone | 215-750-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 711 EUGENIA DR
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City | MEDFORD
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State | NJ
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Zip | 08055-2312
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Country | US
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Telephone | 856-562-5727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07425500
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License Number State | NJ
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